目的　探讨经蝶窦入路切除小儿颅咽管瘤的手术技巧及适应证。　方法　 10例接受了11次经蝶窦手术 ,10次采用唇下 -鼻中隔 -蝶窦入路 ,1次采用鼻外侧 -筛窦 -蝶窦入路 ,在 X线透视监测及显微放大 10～ 15倍下切除肿瘤 ,对未能全切除病例术后加后放疗 1个疗程。　结果　无死亡、无严重并发症 ,全切除 4例 ,次全切除 4例 ,部分切除 2例 ,其中 1例残瘤病例再次经蝶窦手术获得全切除。随访 3个月～ 9年 ,肿瘤消失 5例 ,残瘤静止 4例 ,1例复发。　结论　小儿颅咽管瘤局限于鞍内或伴蝶窦扩大的鞍内 -鞍上型可经蝶窦手术 ,但钙化明显的肿瘤经该入路难以获得令人满意的切除。 Objective To investigate the surgical techniques and indications for the removal of pediatric craniopharyngioma by transsphenoidal approach. Methods Ten cases underwent transsphenoidal sinus surgery, ten times with lip - nasal septum - sphenoid sinus approach, and one with nasal lateral - ethmoid sinus - sphenoid sinus approach. X - ray fluoroscopy and microscopic magnification of 10 ~ 15 times under the excision of the tumor, failed to complete resection of the case plus postoperative radiotherapy 1 course of treatment. Results There were no deaths and no serious complication. Four cases were treated by total resection, four cases were treated by subtotal resection and two cases were partially resected. One case of residual aneurysm was transected via transsphenoidal surgery again. Followed up for 3 months to 9 years, tumor disappeared in 5 cases, residual tumor in 4 cases, 1 case of recurrence. CONCLUSIONS: Pediatric craniopharyngioma is confined to the saddle-to-suprasellar anastomosis or supraspinal anastomosis via suprasellar sinus, but calcified calcification is difficult to obtain satisfactorily by this approach.